[Objective]To compare the effects of continuous femoral nerve block(CFNB) and epidural analgesia(CEA) on rehabilitation after total knee arthroplasty(TKA) surgery. [Methods]Fifty patients undergoing unilateral TKA surgery were randomly divided into group CFNB(n=25) and group CEA(n=25).All patients were received unilateral spinal anesthesia with 0.5% dicaine and given analgesia with 0.2 % ropivacaine with 1ug/ml sufentanil.VAS pain scores during rest and continuous passive movement(CPM) at each time point was recorded.Other parameter such as the angle of initiative flections,blood loss at 6 h post operation,the concentration of serum hemoglobin at 24 h,48 h and side effect were recorded.[Results]The VAS pain scores during test had no significant difference between two groups.The VAS scores of CPM at 24 h and 48 h in group CFNB were obvious lower(3.68?0.93 and 3.93?0.78) than those in group CEA.The initiative flections were similar at 12 and 24 hours after operation.The concentration of hemoglobin at 6 h after operation was lower than that before operation.After reinfusion it was increased but did not reach the level before operation.The incidence of side effects was not noted in both groups.[Conclusion]After TKA surgery,the continuous femoral nerve block can provide better pain relief.No adverse impact on rehabilitation movement of operated legs or blood loss and has less side effect.Therefore,it should be considered an alternative analgesia method after TKA.

OBJECTIVE: To evaluate the quality of Gentiana scabra in Qingre jiedu oral solution. METHODS: HPLC method was established to determine the content of gentiamarin in the oral solution. 299 batches of Qingre jiedu oral solution in circulation were measured and evaluated. RESULTS: Developed HPLC method is simple and reliable. The quality of Qingre jiedu oral solution in circulation is not satisfied. CONCLUSION: Great importance should be attached to the manufacture procedures monitoring of Qingre jiedu oral solution and quality control of G. scabra.

Objective To observe the effect of fluvastatin on the activity of extracellular signal-regulated kinase(ERK)1/2,expression of connective tissue growth factor(CTGF) in glomerular mesangial cells stimulated by high glucose,and explore the pathogenic mechanism of diabetic nephropathy(DN) and its early prevention and treatment.Methods The study consisted of two parts,the first part was to repeat the existing experienment of stimulatory effect of high glucose on mesangial cells,and validated that high glucose could up-regulated the expression of CTGF through stimulating ERK,and the change was unrelated with hypertonic conditions.There were five groups:①normal control group(NG);②high glucose group(HG);③mannitol group(MN);④NG+ERK inhibitor PD98059 group(NG+PD);⑤HG+ ERK inhibitor PD98059 group(HG+PD).The second part was to observe the changes of the expressions of CTGF protein and mRNA in mesangial cells at high glucose concentration before and after fluvastatin intervention.There were also five groups:①normal control group(NG);②high glucose group(HG);③normal glucose and fluvastatin group(NG+F);④high glucose + fluvastatin(HG+F);⑤high glucose + fluvastatin and mevalonic acid group(HG+F+M).The activity of ERK1/2 and the expressions of CTGF protein and mRNA in cultured glomerular mesangial cells stimulated by high glucose were detected with Western blotting and RT-PCR.The amount of fibronectin(FN) in the supernatant of cells was analyzed by ELISA.Intracellular total protein level was measured by Coomassie brilliant blue method.Results The first part showed that the activity of ERK1/2 and the expression of CTGF protein in HG were more higher than those in NG(P

Objective To explore the expression and significance of CD44 gastric cancer stem cell biomarker positive circulating tumor cells (CTC ) in peripheral blood of patients with gastric cancer . Methods From March 2010 to December 2012 ,45 patients with gastric cancer and 20 healthy individuals were enrolled .Peripheral blood samples of all the subjects were collected .The expression of CTC and CD44 postive CTC were detected by density gradient centrifugation method and double immunofluorescent staining .Chi‐square test and t‐test were performed for statistical analysis .Results CTC in peripheral blood of healthy controls were not detected .Among 45 patients with gastric cancer ,CTC were detected in 27 patients and 19 of them were CD44‐positive .The difference in positive rate of CTC expression was statistically significant between two groups (χ2 =10 .986 , P<0 .05) .Among 27 CTC‐positive patients , 19 were proximal gastric cancer and 16 of them were CD44‐positive;16 patients had lymph node metastasis and 14 of them were CD44‐positive;13 patients had distant metastasis and 12 of them were CD44‐positive;14 patients had recurrence and 13 of them were CD44‐positive .The CD44 positive CTC was correlated with tumor location ,lymph node metastasis ,distant metastasis and recurrence (χ2=5 .891 ,5 .527 ,5 .787 and 7 .052 ,respectively ,all P<0 .05) .Furthermore ,in 13 patients with recurrence and CD44 positive CTC ,the recurrence time was (10 .54 ± 5 .55) months which was shorter than that of one patients with CD44 negative CTC (19 months) ,and the difference was statistically significant (t= -3 .654 , P=0 .004) .Conclusions CTC which express cancer stem cell marker may be associated with recurrence and metastasis of gastric cancer .It has more important clinical significance to detect this subtype of CTC .

Objective To explore the correlation between high-risk human papillomavirus(hr-HPV) viral load and severity of cervical lesion. Methods One thousand eight hundred and six women undergoing both hr-HPV DNA test by hybrid capture Ⅱ(HCⅡ) and colposcopic biopsy for histologic results were enrolled in this study.Correlation between hr-HPV viral load and pathological findings was investigated. Results Of 1 806 cases,641(35.5%) patients were positive for HPV DNA.23.2%(301/1299) of women with normal diagnosis had HPV infection,significantly lower than cervical lesion including cervical intraepithelial neoplasia(CIN) and cervical cancer(P=0.000).Associations(odds ratio) among severity of cervical lesion and viral load were calculated.The significantly increased risk only existed between cervical cancer and CIN1 on high viral load(odds ratio,8.5;95% confidence interval,1.0-71.4;P=0.049).Furthermore,viral load values in CIN1,2,3 and cervical cancer were calculated and median analysis revealed non-significant difference(P=0.712). Conclusion The hr-HPV viral load can distinguish cervical lesion as CIN and cervical cancer from normal one,while the prediction of the severity of cervical lesion may be inadequate and need further investigations.

Objective To investigate the temporal expression patterns of the related transcription factors and target genes in cardiomyocyte hypertrophy,and provide valuable clues for further researches on cardiomyocyte hypertrophy.Methods Isoproterenol (ISO) was used to induce ventricular myocytes hypertrophy in neonatal mice.The survival rate of cardiomyocyte was detected by CCK-8,and the average diameters and surface areas of cells were measured by computer photograph analysis system.The mRNA and protein expression levels of related genes were respectively measured by RT-PCR and Western blotting.Results The model of cardiomyocyte hypertrophy stimulated by ISO was constructed successfully.The expression levels of GATA4,MEF2C,GATA5,BNP and ANP increased 24 hours after ISO treatment,the expression levels of P300,α-MHC and TBX5 increased 12 hours after ISO treatment,and of SRF and β-MHC mRNA increased 6 hours after ISO treatment (P＜0.05).The expression levels of GATA4,α-MHC,β-MHC,SRF and P300 mRNA increased firstly,and then decreased in cardiomyocytes induced by ISO.The expression levels of GATA4,SRF,α-MHC,β-MHC and P300 mRNA were still higher than normal (P＜0.05),but of MEF2C decreased to normal (P＞0.0S) 72 hours after ISO treatment.The expression levels continuously elevated of GATA5,TBX5,ANP and BNP mRNA than that of controls (P＜0.05),while no fluctuation was found in NKX2.5 mRNA expression (P＞0.05).The expression of GATA4 protein increased,while of HEY2 protein decreased 48 hours after ISO treatment (P＜0.05).Conclusions In hypertrophic cardiomyocytes,the expression pattern of MEF2C is similar to,but the patterns of GATA5,GATA4,TBX5 and SRF are different with that in the development of heart,implying these genes are important during the process from compensatory stage to decompensation stage.The expression patterns of GATA4,MEF2C and SRF are similar to that of acetylase P300,implying the temporal expressions could be regulated by P300 in cardiomyocyte hypertrophy.

Objective To systematically review the literature evaluating efficacy and adverse events of propranolol for infantile hemangiomas (IHs).Methods We searched the Cochrane,Medline,Wiley,CNKI and Wanfang Databases for all studies on the response of IHs to propranolol only which were published between June 2008 and May 2013.Results A total of 23 studies were collected,including 14 case reports and 2 follow-up studies which were without random and control;another 6 studies were clinical controlled trials and 1 study was RCT.Total 716 patients were included,and never received other treatments before propranolol.Propranolol was initiated at a mean age of (4.5 ± 0.5)months at a mean dose of 2.1 mg/kg/day and for a mean treatment duration of (9.7±9.2) months.The effective rate for patients with IHs treated with propranolol was 97％ (691/716),and patients after treatment completion reported IHs recurred in 8.6 ％ of patients.The adverse effects rate was 31％(223/7167) which most common adverse events were changes in sleep (n=35),gastrointestinal reaction (n =52) and decreased heart rate (n =73),and 5 patients discontinued the treatment because of the serious adverse events.Conclusions This systematic review of 716 patients treated with propranolol for IHs show a high rate of efficacy and a low rate of serious adverse events,and it is a better treatment of infantile hemangioma,but we should pay more attention to the serious adverse events and strictly select indications.

AIM:To investigate the influence of high-mobility group box 1 (HMGB1) on the proliferation of neural stem cells in peri-infarction cortex of focal cerebral ischemia/reperfusion model rats .METHODS: Male SD rats (n=48) were randomly divided into sham group , ischemia/reperfusion (I/R) group, RNA interference group and nega-tive interference group .The rat middle cerebral artery was blocked to establish focal cerebral I /R model ( ischemia for 1 h and reperfusion for 7 d).Lentivirus vector of HMGB1 shRNA was used to suppress the HMGB1 protein expression in the rat brain.The effect of RNA interference was evaluated by the methods of double-immunofluorescence labeling of HMGB 1/GFAP and Western blotting .The proliferation of neural stem cells in the peri-infarction cortex was assessed by double labe-ling of BrdU/nestin.RESULTS: The protein expression of HMGB1 in I/R group was much higher than those in sham group (P<0.05).RNA interference effectively inhibited the HMGB1 expression (P<0.05).Double labeled BrdU/nestin positive cells in I/R group were more than that in sham group (P<0.05).The double labeled BrdU/nestin positive cells were significantly decreased in RNA interference group (P<0.05).CONCLUSION:Focal cerebral ischemia/reperfusion injury promotes the proliferation of neural stem cells in peri-infarction cortex by increasing HMGB 1 protein level .

Objective: To detect circulating tumor cells (CTCs) in patients with gastric cancer and evaluate the relationship among CTCs, clinico-pathological characteristics, and prognosis of gastric cancer. Methods: Peripheral blood samples (10 mL in EDTA) were obtained from 45 patients with gastric cancer. CTCs were detected using density-gradient centrifugation and immunofluo-rescence staining. The clinical significance of the two methods were also compared and investigated. Results:CTC-positive case was defined by the presence of at least one CK19 (+)-CTC per 10 mL of the sample. CTCs were found in 27 of the 45 patients with gastric cancer. The presence of CTCs was significantly correlated with lymph node metastasis, distant metastasis, and recurrence (P=0.007, 0.035, 0.035, respectively). However, CTCs were not significantly correlated with sex, age, tumor location, TNM staging, and tumor differentiation (P>0.05). Conclusion:CTCs were associated with poor prognosis of gastric cancer.

Objective To observe the effect of autophagy inhibitor on the activation of alcohol induced hepatic stel-late cells, and the mechanisms thereof. Methods HSC-T6 cells were cultured in vitro and divided into four groups, includ-ing blank control group, alcohol group, 5 mmol/L 3-MA+alcohol group (low alcohol group) and 10 mmol/L 3-MA+alcohol group (high alcohol group). RT-PCR was used to detect the expression levels ofα-smooth muscle actin (α-SMA) and typeⅠcollagen. The levels of LC3Ⅱ,α-SMA and typeⅠcollagen were detected by Western blot assay. The cell viability of HSC-T6 was detected by MTT assay. Results The mRNA expressions ofα-SMA, typeⅠcollagen and the protein of expressionsα-SMA, typeⅠcollagen and LC3Ⅱwere significantly up-regulated in alcohol group compared with those of control group (P<0.05), while the expressions of those parameters were significantly down-regulated in 10 mmol/L 3-MA+alcohol group (P<0.01). The mRNA and protein levels ofα-SMA and typeⅠcollagen were significantly decreased in two 3-MA-treated groups compared with those in alcohol group (P<0.05). Meanwhile, compared with the 5 mmol/L 3-MA+alcohol group,the protein expressions ofα-SMA, typeⅠcollagen and LC3Ⅱwere significantly decreased in10 mmol/L 3-MA+alcohol group (P < 0.05 ). Compared with the alcohol group,there was significantly lower proliferation activity in all two 3-MA-treated groups (P<0.05). Conclusion 3-MA can inhibit the protein expression of LC3Ⅱ,α-SMA and typeⅠcollagen induced by alcohol in HSC-T6 cells, and inhibit the proliferation of HSC cells.